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1.
Anticancer Res ; 40(1): 501-509, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892605

RESUMO

BACKGROUND: Intensive scientific debate is ongoing about whether moderate solarium use increases melanoma risk. The authors of some recent publications demand the debate be closed and propose "actions against solarium use for skin cancer prevention" because new studies have convincingly demonstrated causality. This minireview aims to investigate whether those demands are sufficiently supported by present scientific knowledge and comply with the principles of evidence-based medicine. MATERIALS AND METHODS: We performed a systematic literature search (through June 2019; PubMed, ISI Web of Science) to identify publications investigating how solarium use affects melanoma risk. RESULTS: We found no studies that demonstrate a causal relationship between moderate solarium use and melanoma risk. Results of cohort and case-control studies published to date, including recent investigations, do not prove causality, and randomized controlled trials providing unequivocal proof are still lacking. Moreover, the overall quality of observational studies is low as a result of severe limitations (including unobserved or unrecorded confounding), possibly leading to bias. We also disagree with recent claims that Hill's criteria for the epidemiological evidence of a causal relationship between a potential causal factor and an observed effect are fulfilled in regard to the conclusion that moderate solarium use per se would increase melanoma risk Conclusion: Current scientific knowledge does not demonstrate a causal relationship between moderate solarium use and melanoma risk. Therefore, the debate is not closed.


Assuntos
Melanoma/epidemiologia , Banho de Sol , Animais , Humanos , Fatores de Risco , Raios Ultravioleta
2.
J Oncol Pharm Pract ; 26(1): 93-98, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30955466

RESUMO

INTRODUCTION: Drug treatment for cancer has changed dramatically over the past decade with many new drugs often with multiple applications. More recently, the detailed pathway for approval from the National Institute for Health and Care Excellence (NICE) in the UK has been simplified. To explore how these changes have impacted on systemic anti-cancer therapy tumour site-specific prescribing and workload activities, we have reviewed the prescribing records for 2014-2018 in a UK cancer network. METHODS: Information about the numbers of new systemic anti-cancer therapy drugs and NICE approvals were obtained from print editions of the British National Formulary (BNF) and the NICE website. Data on the numbers of new chemotherapy courses and individual treatment-related attendances were obtained from the cancer network Chemocare electronic prescribing system. RESULTS: During the five-year study period, there were 49 new systemic anti-cancer therapy drugs for all tumour types, and a total of 65 NICE technology approvals for solid tumour indications. Overall numbers of treatment courses increased by 40.7% and total treatment-related visits by 80.6%. There was a wide variation across tumour types with the highest number of increased visits seen for melanoma (349.3%) and prostate cancer (242.3%), but in contrast, no appreciable increases were seen for lower gastrointestinal cancers or small cell lung cancer. CONCLUSION: The study confirms the major impact of the arrival of new drug technology and positive NICE appraisals on increasing systemic anti-cancer therapy prescribing and chemotherapy unit activity. The data in this study may be of help in planning for future service delivery planning and workforce configurations.


Assuntos
Antineoplásicos/administração & dosagem , Institutos de Câncer/tendências , Redes Comunitárias/tendências , Sistemas de Liberação de Medicamentos/tendências , Drogas em Investigação/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Humanos , Melanoma/tratamento farmacológico , Melanoma/epidemiologia , Reino Unido/epidemiologia
3.
Int J Cancer ; 146(1): 26-34, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30801710

RESUMO

Melanoma of unknown primary (MUP) may have a different biology to melanoma of known primary, but clinical trials of novel therapies (e.g., immune checkpoint or BRAF/MEK inhibitors) have not reported the outcomes in this population. We therefore evaluated the overall survival (OS) among patients with MUP in the era of novel therapy. Data for stage III or IV MUP were extracted from a nationwide database for the period 2003-2016, with classification based on the eighth edition of the American Joint Committee on Cancer criteria. The population was divided into pre- (2003-2010) and post- (2011-2016) novel therapy eras. Also, OS in the post-novel era was compared between patients with stage IV MUP by whether they received novel therapy. In total, 2028 of 65,110 patients (3.1%) were diagnosed with MUP. Metastatic sites were known in 1919 of 2028 patients, and most had stage IV disease (53.8%). For patients with stage III MUP, the 5-year OS rates were 48.5% and 50.2% in the pre- and post-novel eras, respectively (p = 0.948). For those with stage IV MUP, the median OS durations were unchanged in the pre-novel era and post-novel era when novel therapy was not used (both 4 months); however, OS improved to 11 months when novel therapy was used in the post-novel era (p < 0.001). In conclusion, more than half of the patients with MUP are diagnosed with stage IV and the introduction of novel therapy appears to have significantly improved the OS of these patients.


Assuntos
Sistemas de Liberação de Medicamentos , Imunoterapia , Melanoma/terapia , Neoplasias Primárias Desconhecidas/terapia , Idoso , Feminino , Humanos , Masculino , Melanoma/epidemiologia , Melanoma/secundário , Pessoa de Meia-Idade , Neoplasias Primárias Desconhecidas/patologia , Países Baixos/epidemiologia , Análise de Sobrevida
4.
Surg Clin North Am ; 100(1): 1-12, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31753105

RESUMO

The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Raios Ultravioleta/efeitos adversos , Humanos , Melanoma/etiologia , Fatores de Risco , Neoplasias Cutâneas/etiologia , Banho de Sol , Luz Solar/efeitos adversos , Estados Unidos/epidemiologia
5.
Br J Nurs ; 28(17): S10-S14, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31556746

RESUMO

Malignant melanoma cases represented the seventh most common cancer type in Northern Ireland between 2011 and 2015, and the incidence of melanoma cases is expected to rise. Sentinel lymph node biopsy (SLNB) is commonly offered to patients in the UK with malignant melanoma to help in staging their disease, but a commissioned SLNB service is not available in Northern Ireland. This article describes a Florence Nightingale Foundation Travel Scholarship to gain knowledge and experience with the aim of developing and implementing an effective and efficient SLNB service for patients with malignant melanoma in Northern Ireland. A 3-week visit was made to an eminent centre of excellence in skin oncology in the UK.


Assuntos
Melanoma/enfermagem , Melanoma/patologia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/enfermagem , Neoplasias Cutâneas/patologia , Bolsas de Estudo , Humanos , Melanoma/epidemiologia , Irlanda do Norte/epidemiologia , Enfermeiras Clínicas , Neoplasias Cutâneas/epidemiologia , Reino Unido
6.
Nepal J Ophthalmol ; 11(21): 64-73, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31523069

RESUMO

BACKGROUND: Choroidal melanomas are diagnosed in approximately 6 out of one million Americans per year, and although their incidence is low, they are the most common primary intraocular tumor in adults. METHODS: Choroidal melanoma is rare tumors and till date no such reports with sclera involvement has been reported from Nepal. It is a prospective case series. The aim of this study is for awareness of the severity of the Choroidal melanoma and it's management. Besides, it is also to study the demography, presentation, histopathological variations and management of cases of choroidal melanoma. All the consecutive cases of Choroidal melanoma presenting between Jan 2017 to May 2018 and those who were within the inclusion criteria were included in this study. RESULTS: There were eight patients, five male and three female, within age range of 18-73, median age was 47. All patients presented with decreased vision ranging from 6/24 to PL of less then three months to 2 years duration. Fund us showed choroidal mass associated with Vitreous hemorrhage (VH), and retinal detachment (RD). Two patients were managed with enucleation with External beam radiotherapy (EBRT). Four underwent only enucleation. One patient with lesion size less then 10mm under went plaque brachy therapy. One patient underwent initially Plaque brachy therapy but later had to undergo Enucleation. Histopathological examination (HPE) of enucleated patient revealed epitheloid cell melanoma grade three in four and Spindle cell melanoma in three patients. Each one patient of epitheloid cell melanoma and spindle cell melanomahad scleral involvement. Indication for radiotherapy was scleral involvement. CONCLUSION: With 8 cases of Choroidal melanoma in a single year in a single hospitalgives us a clue that there may be much more undiagnosed cases of Choroidal melanomain Nepal that should be taken seriously. Going for annual eye examination with routine dilated fund us exams can help in prevention and early diagnosis of this life and sight threatening condition and to reduce the mortality rate.


Assuntos
Neoplasias da Coroide/diagnóstico , Melanoma/diagnóstico , Acuidade Visual , Adolescente , Adulto , Idoso , Braquiterapia , Neoplasias da Coroide/epidemiologia , Neoplasias da Coroide/terapia , Enucleação Ocular , Feminino , Humanos , Incidência , Masculino , Melanoma/epidemiologia , Melanoma/terapia , Pessoa de Meia-Idade , Nepal/epidemiologia , Oftalmoscopia , Estudos Prospectivos , Microscopia com Lâmpada de Fenda , Adulto Jovem
7.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(6): 434-447, jul.-ago. 2019. graf, tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-185271

RESUMO

El melanoma cutáneo (MC) es el tumor cutáneo que más muertes provoca, con un aumento importante de la incidencia y la mortalidad en las últimas décadas, especialmente en el paciente anciano. Existen evidencias del diferente comportamiento biológico, así como de las diferencias en el manejo del MC en este subgrupo de pacientes con respecto al resto de otras franjas de edad, evidentemente condicionadas por unas limitadas expectativas de supervivencia y calidad de vida ajenas al melanoma y una elevada incidencia de comorbilidades. El presente artículo revisa los datos actuales más relevantes de la epidemiología, etiopatogenia e inmunología, clínica, prevención y manejo del MC en el anciano


Cutaneous melanoma (CM) causes more deaths than any other skin tumor, and incidence and mortality rates have risen in recent years, especially in patients of advanced age. There are differences in the biological behavior of CM tumors in the elderly as well as differential management of the disease, evidently influenced by such factors as limited life expectancy, the high incidence of concomitant conditions in older patients, and issues of quality of life unrelated to CM itself. We review relevant current literature on the epidemiology, etiology, pathogenesis, and immunology of CM as well as research on the clinical features, prevention, and management of these tumors in the elderly


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Melanoma/epidemiologia , Neoplasias Cutâneas/diagnóstico , Sobrevivência , Qualidade de Vida , Prognóstico , Melanoma/mortalidade , Análise Multivariada , Diagnóstico Tardio , Sistemas de Liberação de Medicamentos/métodos , Imunoterapia
8.
World Neurosurg ; 130: e1091-e1097, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31323401

RESUMO

BACKGROUND: Primary melanocytic neoplasms of the central nervous system (CNS) are rare and account for 1% of all melanomas. This study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the epidemiology of primary CNS melanoma and further characterize their treatment. METHODS: Data from the National Cancer Institute SEER program, collected from 1973-2015, were retrospectively analyzed. A total of 86 records of malignant melanoma cases with CNS as the primary site were identified, and 54 patients were studied based on the inclusion criteria. Demographic, tumor, and treatment regimen effectiveness were studied. RESULTS: A total of 54 patients were included in this study. Tumors were distributed evenly in size and localized primarily to the cerebral meninges and spinal cord. A total of 13% of patients underwent biopsy, 40.7% gross total resection (GTR), 7.4% subtotal resection (STR), 46.3% radiation therapy (RT), and 27.3% chemotherapy (CT) in a variety of treatment combinations. GTR alone and STR + RT resulted in increased disease-specific survival compared to biopsy alone, but no survival benefit was found with biopsy with RT and/or CT as well as STR alone. CONCLUSIONS: To our knowledge, this is the largest single database study completed for primary malignant melanoma of the CNS. The study identified the need for tumor resection for the proper treatment of these lesions, particularly GTR. GTR could be paired with adjuvant RT or RT + CT providing survival benefit as well. In cases when GTR is unable to be completed, STR + RT provides significant improvement in survival compared to biopsy alone.


Assuntos
Neoplasias do Sistema Nervoso Central/epidemiologia , Melanoma/epidemiologia , Vigilância da População , Programa de SEER/tendências , Adulto , Idoso , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/epidemiologia , Neoplasias Encefálicas/terapia , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/terapia , Feminino , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/terapia , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos Retrospectivos
9.
AIDS Rev ; 21(2): 65-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31332396

RESUMO

Thanks to the advancement in understanding of molecular mechanisms driving immune surveillance, we have now approached a revolutionary era for the treatment of malignant melanoma (MM). Meanwhile, people living with HIV/AIDS (PLWHA) are aging and non-AIDS-related cancers have become a leading cause of death. Both HIV infection and melanoma share common immune-pathological pathways: immune checkpoints are being targeted for melanoma immunotherapy and investigated as a "shock and kill" strategy for latency reversion among HIV-positive individuals. Nevertheless, a substantial lack of information exists on epidemiology, clinical features, and management of MM in HIV, due to compartmentalized approaches and poor awareness about the problem. In this narrative review, we aimed at analyzing available data regarding MM in PLWHA to point out key knowledge gaps and future opportunities from an integrated dermatology, oncology, and infectious diseases standpoint. To date, a strong association between HIV infection and MM risk still needs to be effectively demonstrated; nevertheless, once this cancer has developed in HIV-positive people, it shows more aggressive course, worse prognosis, and seemingly peculiar clinical and histological features. Despite these challenges, a syndemic framework should lead us toward a tailored and multidisciplinary approach not to miss valuable opportunities from the worst situations including the enrolment of HIV-positive patients in the ongoing trials with immune checkpoint inhibitors.


Assuntos
Gerenciamento Clínico , Infecções por HIV/complicações , Melanoma/diagnóstico , Melanoma/terapia , Ensaios Clínicos como Assunto , Humanos , Fatores Imunológicos/uso terapêutico , Melanoma/epidemiologia
10.
Medicine (Baltimore) ; 98(28): e16328, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305421

RESUMO

Recently, the effectiveness of novel immune checkpoint inhibitors and BRAF-directed therapies has been demonstrated in advanced melanoma trial populations. Limited research, however, has evaluated the impact of these therapies in a real-world setting. The aim of this study was to evaluate treatment patterns and clinical outcomes among advanced melanoma patients treated with modern therapies within community oncology clinics. Adult patients with advanced melanoma who initiated treatment within the US Oncology Network between 1/1/14 and 12/31/16 were included. Data were sourced from electronic healthcare records. Patients were followed through 12/31/17. Descriptive analyses were performed to assess patient and treatment characteristics and Kaplan-Meier methods were used for time-to-event outcomes. In total, 484 patients met eligibility criteria (32.0% with brain metastasis, 12.6% with Eastern Cooperative Oncology Group performance status ≥2). In the first-line (1L) setting during the study period, 37.0% received anti-PD1 monotherapies, 26.4% ipilimumab monotherapy, 19.8% BRAF/MEK combination therapy, 6.4% BRAF or MEK monotherapy, 4.1% ipilimumab/nivolumab combination therapy and 6.2% other regimens. Differences in baseline demographic and clinical characteristics were observed across treatment groups. For the overall study population, the median (95% confidence interval) estimates for overall survival, time to next treatment and progression-free survival were 20.7 (16.0, 26.8), 5.8 (5.3, 6.5), and 4.9 (4.2, 5.7) months, respectively. The results of this study provide real-world insight into advanced melanoma treatment trends and clinical outcomes, including high utilization of immunotherapies and BRAF/MEK combination therapy. Future research can explore underlying differences in patient subpopulations and the sequence of therapies across lines of therapy.


Assuntos
Melanoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Melanoma/epidemiologia , Melanoma/patologia , Pessoa de Meia-Idade , Padrões de Prática Médica , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
11.
Cancer Causes Control ; 30(9): 909-922, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31300947

RESUMO

PURPOSE: Childhood cancer survivors are at increased risk of developing subsequent malignant neoplasms (SMNs). We compared survival and clinical characteristics of survivors with SMNs (sarcoma, breast cancer, or melanoma) and a population-based sample of similar first malignant neoplasm (FMN) patients. METHODS: We assembled three case series of solid SMNs observed in a cohort of 5-year Dutch childhood cancer survivors diagnosed 1963-2001 and followed until 2014: sarcoma (n = 45), female breast cancer (n = 41), and melanoma (n = 17). Each SMN patient was sex-, age-, and calendar year-matched to 10 FMN patients in the population-based Netherlands Cancer Registry. We compared clinical and histopathological characteristics by Fisher's exact tests and survival by multivariable Cox regression and competing risk regression analyses. RESULTS: Among sarcoma-SMN patients, overall survival [hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.23-2.87] and sarcoma-specific mortality (HR 1.91, 95% CI 1.16-3.13) were significantly worse compared to sarcoma-FMN patients (foremost for soft-tissue sarcoma), with 15-year survival rates of 30.8% and 61.6%, respectively. Overall survival did not significantly differ for breast-SMN versus breast-FMN patients (HR 1.14, 95% CI 0.54-2.37), nor for melanoma-SMN versus melanoma-FMN patients (HR 0.71, 95% CI 0.10-5.00). No significant differences in tumor characteristics were observed between breast-SMN and breast-FMN patients. Breast-SMN patients were treated more often with mastectomy without radiotherapy/chemotherapy compared to breast-FMN patients (17.1% vs. 5.6%). CONCLUSIONS: Survival of sarcoma-SMN patients is worse than sarcoma-FMN patients. Although survival and tumor characteristics appear similar for breast-SMN and breast-FMN patients, treatment differs; breast-SMN patients less often receive breast-conserving therapy. Larger studies are necessary to substantiate these exploratory findings.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Melanoma/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Sarcoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Países Baixos , Análise de Sobrevida
12.
Emerg Infect Dis ; 25(8): 1600-16002, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310208

RESUMO

Cutavirus was previously found in cutaneous melanoma. We detected cutavirus DNA in only 2/185 melanoma biopsies and in 0/52 melanoma metastases from patients in Germany. Viral DNA was localized in the upper epidermal layers. Swab specimens from healthy skin were cutavirus positive for 3.8% (9/237) of immunocompetent and 17.1% (35/205) of HIV-positive men.


Assuntos
Melanoma/epidemiologia , Melanoma/etiologia , Infecções por Parvoviridae/complicações , Parvovirus , Biópsia , DNA Viral , Alemanha/epidemiologia , Humanos , Melanoma/diagnóstico , Estadiamento de Neoplasias , Infecções por Parvoviridae/virologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Carga Viral
13.
Mayo Clin Proc ; 94(7): 1287-1295, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31272570

RESUMO

OBJECTIVE: To investigate an association between tumor necrosis factors-alpha (TNFα) inhibitors or other immunosuppressants and the development of uveal and cutaneous melanoma. PATIENTS AND METHODS: We performed a retrospective incidence and case-control analysis of patients in Olmsted County, MN, who were diagnosed with uveal or cutaneous melanoma from January 1, 2000, to December 31, 2014. Incidence was adjusted by age and gender to the 2010 US white population. Controls were matched by sex and age to cases at time of diagnosis of melanoma. RESULTS: There were 1221 cases of melanoma (33 uveal, 1188 cutaneous). Combined incidence of uveal and cutaneous melanoma per 100,000 person-years varied by gender (male > female), age (older > younger), and time period: 2010 to 2014 (77.9, 95% confidence interval [CI], 71.1-84.7) ≈ 2005 to 2009 (78.0, 95% CI, 70.9-85.0) > 2000 to 2004 (42.5, 95% CI, 36.9-48.1, P<.001). TNFa inhibitor prescription was not associated with significantly increased risk of melanoma vs controls (1.06% vs 0.41%, P=.06). Immunosuppressive agents, high-dose corticosteroids, and topical immunosuppressants were associated with melanoma (odds ratio [OR] 1.42 CI, 1.03-1.95, 3.30 CI, 2.44-4.48, and 1.87 CI, 1.06-3.28, respectively). An increased number of patients with uveal melanoma received immune modulating agents vs controls, but this was not statistically significant (P=.36). Autoimmune disease itself was not correlated with melanoma (P=.73). CONCLUSION: Exposure to immunosuppressive agents is associated with melanoma. TNFa inhibition and autoimmune disease alone do not significantly increase risk of melanoma. In patients receiving immunosuppressive treatments, physicians should consider monitoring with dilated ophthalmic and full-body skin examinations. Further studies are needed to assess the impact of TNFa inhibitors on development of melanoma, particularly in uveal melanoma.


Assuntos
Imunossupressores/efeitos adversos , Melanoma/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Fator de Necrose Tumoral alfa/efeitos adversos , Neoplasias Uveais/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Melanoma/epidemiologia , Melanoma/patologia , Pessoa de Meia-Idade , Minnesota/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/uso terapêutico , Neoplasias Uveais/epidemiologia , Neoplasias Uveais/patologia
14.
Dermatology ; 235(5): 396-399, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31269484

RESUMO

The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.


Assuntos
Melanoma/mortalidade , Neoplasias Cutâneas/mortalidade , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Melanoma/epidemiologia , Melanoma/etnologia , Mortalidade/tendências , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etnologia , África do Sul/epidemiologia
15.
Genes (Basel) ; 10(7)2019 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-31262050

RESUMO

Despite recent genetic advances and numerous ongoing therapeutic trials, malignant melanoma remains fatal, and prognostic factors as well as more efficient treatments are needed. The development of such research strongly depends on the availability of appropriate models recapitulating all the features of human melanoma. The concept of comparative oncology, with the use of spontaneous canine models has recently acquired a unique value as a translational model. Canine malignant melanomas are naturally occurring cancers presenting striking homologies with human melanomas. As for many other cancers, dogs present surprising breed predispositions and higher frequency of certain subtypes per breed. Oral melanomas, which are much more frequent and highly severe in dogs and cutaneous melanomas with severe digital forms or uveal subtypes are subtypes presenting relevant homologies with their human counterparts, thus constituting close models for these human melanoma subtypes. This review addresses how canine and human melanoma subtypes compare based on their epidemiological, clinical, histological, and genetic characteristics, and how comparative oncology approaches can provide insights into rare and poorly characterized melanoma subtypes in humans that are frequent and breed-specific in dogs. We propose canine malignant melanomas as models for rare non-UV-induced human melanomas, especially mucosal melanomas. Naturally affected dogs offer the opportunity to decipher the genetics at both germline and somatic levels and to explore therapeutic options, with the dog entering preclinical trials as human patients, benefiting both dogs and humans.


Assuntos
Doenças do Cão/genética , Melanoma/genética , Animais , Modelos Animais de Doenças , Doenças do Cão/epidemiologia , Doenças do Cão/patologia , Cães , Humanos , Melanoma/epidemiologia , Melanoma/patologia , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Uveais/epidemiologia , Neoplasias Uveais/genética , Neoplasias Uveais/patologia
16.
World Neurosurg ; 129: e782-e790, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31203063

RESUMO

INTRODUCTION: Primary central nervous system (pCNS) melanoma is an extremely rare malignant tumor. We explored the incidence, outcomes, and predictors of pCNS melanoma. METHODS: We queried the Surveillance, Epidemiology, and End Results database to identify all patients diagnosed with pCNS melanoma during 1973-2015. Overall survival (OS) was obtained by using the Kaplan-Meier curves. Log-rank test was used to compare survival across groups of age, sex, race, tumor location, size, surgical resection, radiotherapy, chemotherapy and year of diagnosis. Cox regression was used for univariate and multivariate analysis of survival. RESULTS: A total of 84 pCNS melanomas were identified with a 5-year OS of 37.7%. The overall age-adjusted incidence rate was 0.52 per 10,000,000 person-years. Age ≤19 years (vs. age 20-59 years, hazard ratio [HR] = 2.37, 95% confidence interval [CI]: 1.11-5.07, P = 0.03) and intracranial location (vs. intraspinal, HR = 1.98, 95% CI: 1.04-3.77, P = 0.04) were associated with decreased survival rate. Gross total resection surgery (vs. partial resection, HR = 0.31, 95% CI: 0.15-0.66, P = 0.002) was associated with improved survival rate. There was no significant association between other demographic characteristics, tumor size, therapy methods, year of diagnosis, and OS. CONCLUSIONS: The overall age-adjusted incidence rate of pCNS melanoma is 0.52 per 10,000,000 person-years. Age ≤19 years and intracranial tumor location are independent risk factors of low survival rate, whereas gross total resection is associated with better survival rate.


Assuntos
Neoplasias do Sistema Nervoso Central/epidemiologia , Melanoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Nervoso Central/mortalidade , Neoplasias do Sistema Nervoso Central/patologia , Neoplasias do Sistema Nervoso Central/terapia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Melanoma/mortalidade , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Programa de SEER , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
17.
Future Oncol ; 15(21): 2471-2477, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31161801

RESUMO

Aim: In the UK, there are limited data sources for evaluating real-world research questions related to oncology therapy. We conducted a pilot study to investigate the feasibility of extracting data directly from a chemotherapy prescription platform (ChemoCare®) utilized in standard care. Patients & methods: Concordance was compared with data extracted manually for patients with advanced melanoma as part of a concurrent chart review (gold-standard) using Cohen's kappa and the intraclass correlation coefficient. Results: There was high concordance between data automatically extracted from the prescription platform and chart review data. Conclusion: This pilot can be used as a framework for future studies using direct, automated extraction from prescription platforms.


Assuntos
Prescrições de Medicamentos/estatística & dados numéricos , Oncologia , Neoplasias/epidemiologia , Prescrições de Medicamentos/normas , Humanos , Oncologia/métodos , Oncologia/normas , Melanoma/tratamento farmacológico , Melanoma/epidemiologia , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Projetos Piloto , Reprodutibilidade dos Testes , Reino Unido/epidemiologia
20.
J Am Acad Dermatol ; 81(2): 489-499, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31230976

RESUMO

BACKGROUND: Previous studies have found familial aggregation of melanoma and keratinocyte cancers (KCs). OBJECTIVE: We sought to determine the risk of melanoma and KCs in those with a positive family history of melanoma while controlling for pigmentary and environmental risk factors. METHODS: We prospectively followed 216,115 participants from the Nurses' Health Study, Nurse's Health Study 2, and Health Professionals Follow-up Study for more than 20 years. Cox proportional hazards regression controlling for known risk factors for skin cancer was used to estimate association between family history of melanoma and melanoma and KCs. RESULTS: Compared with those without a family history of melanoma, individuals with a family history of melanoma had a 74% increased risk of melanoma (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.45-2.09), a 22% increased risk of squamous cell carcinoma (HR, 1.22; 95% CI, 1.06-1.40), and a 27% increased risk of basal cell carcinoma (HR, 1.27; 95% CI, 1.12-1.44). Family history of melanoma increased the risk of development of truncal melanoma in both sexes, extremity melanoma in women, and extremity squamous cell carcinoma in women. LIMITATIONS: Limitations of this study include self-reported family history and detection bias. CONCLUSION: Individuals with a family history of melanoma are at an increased risk of melanoma and KCs.


Assuntos
Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Extremidades , Saúde da Família , Feminino , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Melanoma/genética , Pessoa de Meia-Idade , Linhagem , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais , Neoplasias Cutâneas/genética , Tronco , Estados Unidos/epidemiologia
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